Community Care Home   Community Care on Facebook  Community Care on LinkedIn   

Contact Us At:

1-866-992-6600

Certify Your 1-2 Bed Home

Prior Authorization and Authorization Requirements for PACE (Program of All-inclusive Care for the Elderly), Family Care Partnership and Family Care Program. 

To  understand what services (Medical and LTC) require authorizations please review the following document:

Prior Authorization Requirement 

Authorizations and Forms for Medicare's Patient Driven Payment Model (PDPM)

To be in compliance with Medicare’s Patient Driven Payment Model (PDPM) beginning October 1st, 2019, Community Care’s prior authorization practice for post-acute facility Part A Medicare skilled nursing stays is changing for all Medicare beneficiaries enrolled in Community Care’s PACE and Family Care Partnership programs. Skilled Nursing facilities will be required to complete Community Care’s “Post-Acute Facility Prior Authorization Request Form” (found in Forms section below) when admitting a PACE or Family Care Partnership member under a Part A Medicare stay. Completed forms must be sent to Community Care’s Utilization Management department before any authorization will be completed. Once a Medicare Part A stay is authorized by Community Care, Providers must then complete Community Care’s “Post-Acute Facility Continued Stay Review Form” weekly during the Part A stay providing updates to the progression of the member’s initial plan of care. 



Home   |   Who We Are   |   Members & Families   |   For Providers   |   Careers   |   Consulting Services   |   Contact Us



 Corporate Headquarters: 205 Bishops Way, Brookfield, WI 53005
Phone: (414) 231-4000 Toll Free: 1-866-992-6600 TTY: Call the Wisconsin Relay System at 711
Help in Other Languages
 
© 2014-2019, Community Care, Inc. - All Rights Reserved   |   Privacy Policy   |   Terms of Use